Clinical utility of the liver frailty index for predicting sarcopenia in chronic liver disease patients with hepatocellular carcinoma.

Objective: To determine the accuracy of liver frailty Index (LFI) to predict sarcopenia in patients of chronic liver disease (CLD) with hepatocellular Carcinoma (HCC). Study Design: Cross-sectional study. Setting: Outpatient Department of the Gastroenterology, Liaquat National Hospital, Karachi, Pakistan. Period: August 2022 to February 2023. Methods: A total of 110 patients aged 45-70 years, having CLD with HCC were analyzed. Frailty was classified on the basis of LFI as robust (< 3.2), prefrail (3.2-4.4), and frail (≥ 4.5). Muscle atrophy was evaluated by skeletal mass muscle index (SMI) evaluated through CT scan at L3 region. Results: In a total of 110 patients, 62 (56.4%) were male. The mean age was 57.93±6.86 years. The mean LFI was 3.93±0.76. Forty-five (40.9%) patients were classified as frail. The distribution of frailty was not significantly with respect to gender (p=0.649), or CLD type (p=0.788). Child Pugh classification (p<0.001), and HCC staging (p<0.001) were found to have significant association with frailty. Sarcopenia was documented in 74 (67.3%) patients with HCC. Gender (p=0.183), BMI (p=0.533), and CLD types (p=0.448) were not found to have any significant association with sarcopenia. Child-Pugh classification (p<0.001), and HCC staging (p<0.001) were having significant association with sarcopenia. Frailty was found to depict significant linkage with sarcopenia (p<0.001). Conclusion: Frailty, as assessed by LFI, shows a strong association with sarcopenia, independent of gender and CLD type. Child-Pugh classification and HCC stage were identified as important predictors of both frailty and sarcopenia.